Provider Demographics
NPI:1508350281
Name:VAN HUBEN, ANNE MARGARET (OT)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:MARGARET
Last Name:VAN HUBEN
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8106 REGENCY PARK APTS N
Mailing Address - Street 2:
Mailing Address - City:QUEENSBURY
Mailing Address - State:NY
Mailing Address - Zip Code:12804-1438
Mailing Address - Country:US
Mailing Address - Phone:845-242-1375
Mailing Address - Fax:
Practice Address - Street 1:ELDERWOOD AT NORTH CREEK
Practice Address - Street 2:112 SKI BOWL ROAD
Practice Address - City:NORTH CREEK
Practice Address - State:NY
Practice Address - Zip Code:12853
Practice Address - Country:US
Practice Address - Phone:845-251-4722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-18
Last Update Date:2018-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022284225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist